Artículos

Rationale aims and objectives The available evidence on the use of heuristics and their relationship with diagnostic error in primary care is very limited. The aim of the study is to identify the use of unknown thought and specifically the possible use of Representativeness, Availability and overconfidence heuristics in the clinical practice of primary care…

Health technology assessment (HTA) is increasingly informed by nonrandomized studies, but there is limited guidance from HTA bodies on expectations around evidence quality and study conduct. We developed recommendations to support the appropriate use of such evidence based on a pragmatic literature review and a workshop involving 16 experts from eight countries as part of the…

Many adult cancer patients present one or more physical comorbidities. Besides interfering with treatment and prognosis, physical comorbidities could also increase the already heightened psychological risk of cancer patients. To test this possibility, we investigated the relationship between physical comorbidities with depression symptoms in a sample of 2073 adult cancer survivors drawn from the nationally…

This article presents part of the work within Work Package 3 (WP3) of Impact HTA (Improved methods and actionable tools for enhancing HTA), a H2020 EU-funded research project, intended to enhance and promote collaboration in HTA across EU MS. Amongst other objectives, and in close collaboration with WP4, WP3 addressed setting up a multi-country unit-cost…

Background A core evaluation framework that captures the health care and societal benefits of value added medicines (VAMs, also often called repurposed medicines) was proposed in Report 1, aiming to reduce the heterogeneity in value assessment processes across countries and to create incentives for manufacturers to invest into incremental innovation. However, this can be impactful…

Background Findings and limitations of previous studies on persistent organic pollutants (POPs) and pancreatic cancer risk support conducting further research in prospective cohorts. Methods We conducted a prospective case-control study nested within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. Participants were 513 pancreatic cancer cases and 1020 matched controls. Concentrations of 22…

Enthusiasm for the use of outcomes-based managed entry agreements (OBMEAs) to manage uncertainties apparent at the time of appraisal/pricing and reimbursement of new medicines has waned over the past decade, as challenges in establishment, implementation and re-appraisal have been identified. With the recent advent of innovative treatments for rare diseases that have uncertainties in the…

The paper “Should governments buy the drug patents?” published 13 years ago in this same journal [1] reflected on aspects that have become relevant again, both for good and bad reasons. The last 60 years have seen huge advances in many of the scientific, technological, and managerial factors that raises the efficiency of commercial medicines research…

Purpose Excess iron is involved in the development of non-communicable diseases such as cancer, type 2 diabetes and cardiovascular conditions. We aimed to describe the prevalence of excess iron and its determinants in healthy European adults. Methods Sociodemographic, lifestyle, iron status, dietary information, and HFE genotyping were obtained from controls from the nested case–control study…

Los medicamentos antiinflamatorios no esteroideos (AINEs) se encuentran entre los medicamentos más consumidos mundialmente. Esto hace necesario realizar una síntesis amplia de la evidencia disponible sobre la prescripción segura y adecuada de AINEs en pacientes con enfermedad cardiovascular, enfermedad renal crónica, hipertensión, insuficiencia cardíaca o cirrosis hepática y en población general. Para ello se ha…

The geographical distribution of mortality has frequently been studied. Nevertheless, those studies often consider isolated causes of death. In this work, we aim to study the geographical distribution of mortality in urban areas, in particular, in 26 Spanish cities. We perform an overall study of 16 causes of death, considering that their geographical patterns could…

Introduction Asset-based community development (ABCD) is a strategy aimed at strengthening communities of interest through the identification and enhancement of those protective resources (also called ‘health assets’) that contribute to improve population health. Although primary care is specially well placed to contribute to ABCD by facilitating patients’ access to community health assets, the implementation of…

La investigación científica no puede dar la espalda a los nuevos hábitos de consumo de la información. En este nuevo escenario donde está disminuyendo de manera generalizada la capacidad de atención, las nuevas generaciones utilizan cada vez con más frecuencia el vídeo como herramienta clave para el acceso al conocimiento. En este sentido, parece oportuno,…

The recently developed scheduled mobile-telephone referral model (DETELPROG) has achieved especially important results in reducing waiting days for patients, but it has been decided to explore what barriers and positive aspects were detected by both primary care physicians (PCPs) and hospital attending physicians (HAPs) regarding its use. For this, a qualitative descriptive study was carried…

Background Patient access to orphan medicinal products (OMPs) is limited and varies between countries, reimbursement decisions on OMPs are complex, and there is a need for more transparent processes to know which criteria should be considered to inform these decisions. This study aimed to determine the most relevant criteria for the reimbursement of OMPs in…

Background: DESDE-LTC (Description and Evaluation of Services and DirectoriEs for Long-Term Care) is an international classification system that allows standardized coding and comparisons between different territories and care sectors, such as health and social care, in defined geographic areas. We adapted DESDE-LTC into a computer tool (DESDE-AND) for compiling a directory of care services in…

La diabetes mellitus (DM) es una enfermedad compleja y multifactorial que requiere un proceso integrado de actividades y diferentes niveles de medición de resultados1. El cuidado transdisciplinario (CTD) es la prestación conjunta que asocia diferentes entornos y disciplinas con interacciones continuas entre el sistema de salud y social en los que cada persona está inmersa…

The liver plays a prominent role in maintenance of homeostasis and is the major organ for xenobiotic metabolism, including pesticides. Conventional liver function tests are widely used to assess hepatocellular and biliary system dysfunction by measuring serum levels of aminotransferases (ALT, AST) and cholestasis enzymes (alkaline phosphatase –ALP– and γ-glutamyl transferase –GGT–), respectively. Although these…

La violencia sexual, incluyendo las agresiones sexuales facilitadas por drogas, es un serio problema cada vez más común en los contextos de ocio nocturno. Este trabajo estudia las actitudes y percepciones de la juventud española en torno a la violencia sexual en dicho ámbito. Los participantes se reclutaron mediante muestreo en bola de nieve. Se…

In the course of the COVID-19 pandemic, it has become clear that primary healthcare systems play a critical role in clinical care, such as patient screening, triage, physical and psychological support and also in promoting good community advice and awareness in coordination with secondary healthcare and preventive care. Because of the role of social and…

To evaluate the impact of a psychoeducational, mobile health intervention based on cognitive behavioural therapy and mindfulness‐based approaches on the mental health of healthcare workers at the frontline against COVID‐19 in Spain. Design We will carry out a two‐week, individually randomized, parallel group, controlled trial. Participants will be individually randomized to receive the PsyCovidApp intervention…

Background: Observational evidence has shown that smoking is a risk factor for breast and colorectal cancer. We used Mendelian randomization (MR) to examine causal associations between smoking and risks of breast and colorectal cancer. Methods: Genome-wide association study summary data were used to identify genetic variants associated with lifetime amount of smoking (n=126 variants) and…

In Latin America, ‘judicialization’ for access to healthcare refers to thousands of different claims, conditions, technologies and circumstances. Its impact depends on what is ‘judicialized’, why, for which benefit, and at what cost to society. Since judges cannot, by themselves, reduce medical uncertainty – or price tags – their health systems are exposed to costly…

Background The management regarding metastatic colorectal cancer throughout Europe is not well known. Aims To draw a European comparison of the management and prognosis of metastatic colorectal cancers. Methods Factors associated with chemotherapy administration were identified through logistic regressions. Net survival was estimated and crude probabilities of death related to cancer and other causes using…

Background: A growing body of evidence suggests that alterations of dietary fatty acid (FA) profiles are associated with colorectal cancer (CRC) risk. However, data from large-scale epidemiological studies using circulating FA measurements to objectively assess individual FA and FA categories are scarce. Methods: To investigate the association between red blood cell (RBC) membrane FAs and…

Aims Physical and psychiatric comorbidities are common in cancer patients and could impact their treatment and prognosis. However, the evidence base regarding the influence of comorbidities in the management and health service use of patients is still scant. In this research we investigated how physical comorbidities are related to the mental health and help‐seeking of…

Alcohol consumption is causally linked to several cancers but the evidence for stomach cancer is inconclusive. In our study, the association between long‐term alcohol intake and risk of stomach cancer and its subtypes was evaluated. We performed a pooled analysis of data collected at baseline from 491 714 participants in the European Prospective Investigation into Cancer…

Environmental Impact Assessment (EIA) is applied to infrastructure and other large projects. The European Union EIA Directive (2011/92/EU as amended by 2014/52/EU) requires EIAs to consider the effects that a project might have on human health. The International Association for Impact Assessment and the European Public Health Association prepared a reference paper on public health…

Background Pancreatic cancer (PC) is a complex disease in which both non-genetic and genetic factors interplay. To date, 40 GWAS hits have been associated with PC risk in individuals of European descent, explaining 4.1% of the phenotypic variance. Methods We complemented a new conventional PC GWAS (1D) with genome spatial autocorrelation analysis (2D) permitting to…

The predictive value of work ability for several health and occupational outcomes is well known. Maintaining the ability to work of all employees has become an important topic in research although some evidence suggests that some groups of workers need greater attention than others. Healthcare workers (x¯ = 54.46 ± 5.64 years) attending routine occupational…

Humans are exposed to a myriad of chemical substances in both occupational and environmental settings. Persistent organic pollutants (POPs) have drawn attention for their adverse effects including cancer and endocrine disruption. Herein, the objectives were 1) to describe serum and adipose tissue retinol levels, along with serum retinol binding protein 4 (RBP4) concentrations, and 2)…

“Age-Friendly Cities and Communities” is an initiative launched by the WHO in 2007 that has spread to more than 1000 cities and communities around the world. This initiative is based on an integrated physical and social environment for older people, and a model of participatory, collaborative governance. An enabling social environment setting is just as…

Objetivo Analizar la ratio paciente-enfermera y su asociación con los resultados en salud en hospitales públicos del Servicio Andaluz de Salud (SAS). Método Estudio ecológico transversal realizado en unidades de adultos de 26 hospitales públicos andaluces. Se recogieron datos de estructura (camas, tipo de unidad, control de enfermería), de gestión (estancia media, índice de utilización…

Background Nutrition and lifestyle have been long established as risk factors for colorectal cancer (CRC). Modifiable lifestyle behaviours bear potential to minimize long-term CRC risk; however, translation of lifestyle information into individualized CRC risk assessment has not been implemented. Lifestyle-based risk models may aid the identification of high-risk individuals, guide referral to screening and motivate…

This research aims to explore clusters of a mixture of 15 Persistent Toxic Substances (PTSs) in the adipose tissue of 227 individuals of an adult cohort from Granada Province (Southern Spain). Information about residence and occupation during participants lifetime was gathered by means of validated questionnaires. Clusters of pollutants in the study population were identified…

Background This study provides updated information on Kaposi sarcoma (KS) in Europe during 1995–2007 from the RARECARENet project. Methods Data comes from 59 population-based cancer registries in 22 countries. KS was defined as ICD-O-3 morphology code 9140 combined with any topography code. Crude and age-adjusted incidence rates and relative survival for years of diagnosis 2000–2007…

OBJECTIVE Islet autoimmunity is associated with diabetes incidence. We investigated whether there was an interaction between dietary fish intake or plasma phospholipid n-3 polyunsaturated fatty acid (PUFA) concentration with the 65-kDa isoform of GAD (GAD65) antibody positivity on the risk of developing adult-onset diabetes. RESEARCH DESIGN AND METHODS We used prospective data on 11,247 incident…

Background The concept of workability provides a conceptual framework and proposes measures for the evaluation of relevant actions focused on a healthy workforce. In Spain, one of the countries with the highest life expectancy, there are practically no scientific studies on workability and its associated factors. Aims The objective of this study is to examine…

La pandemia de COVID-19ha afectado de manera particularmente intensa a España, pese a su nivel de desarrollo y la elogiada solidez de su Sistema Nacional de Salud. Para comprender qué ha pasado e identificar cómo mejorar la respuesta creemos imprescindible una evaluación independiente multidisciplinaria de la esfera sanitaria, política y socioeconómica. En este trabajo proponemos…

Colorectal cancer risk can be lowered by adherence to the World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) guidelines. We derived metabolic signatures of adherence to these guidelines and tested their associations with colorectal cancer risk in the European Prospective Investigation into Cancer cohort. Methods Scores reflecting adherence to the WCRF/AICR recommendations (scale, 1–5)…

Objetivo Elaborar una herramienta de apoyo que ayude a tomar decisiones en el marco de la pandemia de COVID-19. Método Se parte de una búsqueda de diferentes recomendaciones éticas surgidas en España sobre priorización de recursos sanitarios escasos en la pandemia de COVID-19, así como de una revisión narrativa de modelos teóricos sobre distribución en…

La transmisión del SARS-CoV-2 es un problema de Salud Pública de máxima importancia que está influido por diversos factores. Recientemente se ha planteado la hipótesis de que esta transmisión puede reducirse durante el verano debido a la temperatura cálida. Por otro lado, se está estudiando la posible relación entre el elevado número de contagios de…

Objetivo Conocer las repercusiones del confinamiento por la pandemia de COVID-19 en los autocuidados de personas con enfermedades crónicas y en su salud percibida, e identificar factores para el manejo y la gestión de su enfermedad en situaciones de emergencia. Método Estudio cualitativo realizado en marzo-abril de 2020, durante el confinamiento por la pandemia de…

Objective Health quarantines produce serious deterioration in psychological health, which becomes more affected the longer the quarantine lasts. According to the Conservation of Resources theory from Hobfoll (1989, American Psychologist, 44, 513), those people who have a good supply of resources will be able to cope better with the adversities and will show less distress. The…

Editor 2.0 Journal of Healthcare Quality Research El mes de agosto de 2020, la revista The Lancet 1 publicaba una carta de 20 investigadores españoles pidiendo una evaluación independiente, exhaustiva, integral y multidisciplinar de la gestión de la pandemia en España a nivel del gobierno central y de los gobiernos de las CCAA. Posteriormente, en…

The ongoing pandemic of COVID-19 has already had serious worldwide health, socio-economic, political, and educational consequences. In the present study, we investigated what factors can motivate young adults to comply with the recommended preventive measures against coronavirus infection. Even though young people are less likely to suffer severe medical consequences from the virus, they can…

In relation to COVID-19, little research has focused on the study of variables that affect well-being during this pandemic. The purpose of this research is twofold: (1) to find out if people experiencing a quarantine are able to appreciate any positive aspects of it, and to analyze how these responses are categorized and (2) to…

Background Epidemiological evidence indicates that diets rich in plant foods are associated with a lower risk of ischaemic heart disease (IHD), but there is sparse information on fruit and vegetable subtypes and sources of dietary fibre. This study examined the associations of major plant foods, their subtypes and dietary fibre with risk of IHD in…

Background The prevalence of arterial hypertension (AHT), a well-known risk factor for cardiovascular disease, has considerably increased over last decades. Non-persistent environmental pollutants (npEPs) are a group of ubiquitous chemicals, widely used in consumer products such as food packaging and cosmetics, which have been identified as endocrine disrupting chemicals and obesogens. The aim of this…

Objetivo: Analizar la influencia de factores socioeconómicos, demográficos, epidemiológicos y estructura del sistema de salud en la evolución del COVID-19 en Brasil. Métodos: Estudio ecológico con variables extraídas de bancos de datos, teniendo la incidencia y mortalidad por COVID-19 hasta 23 de agosto de 2020, en estados brasileños, como variables respuesta. Las relaciones han estimadas…

OBJECTIVE Higher plasma vitamin C levels are associated with lower type 2 diabetes risk, but whether this association is causal is uncertain. To investigate this, we studied the association of genetically predicted plasma vitamin C with type 2 diabetes. RESEARCH DESIGN AND METHODS We conducted genome-wide association studies of plasma vitamin C among 52,018 individuals of European…

Type 2 diabetes (T2D) is a global public health challenge. Whilst the advent of genome-wide association studies has identified >400 genetic variants associated with T2D, our understanding of its biological mechanisms and translational insights is still limited. The EPIC-InterAct project, centred in 8 countries in the European Prospective Investigations into Cancer and Nutrition study, is…

La llegada de una vacuna contra el SARS-CoV-2 que pueda frenar la expansión de la infección se ha postulado como la respuesta definitiva para frenar la pandemia de COVID-19. Lejos de ser una solución libre de conflictos éticos, la introducción de una nueva vacuna en la práctica de la salud pública, y que se haga…

Las películas son una experiencia cultural para entender la realidad, pero la realidad es compleja y multidimensional, incomprensible sin la dimensión moral de los hechos que tenemos ante nuestros ojos. La ética narrativa nos permite imaginar ese fondo moral de todos los procesos que acompañan la salud y la enfermedad, en lo individual y en…

Objective: Identify risk factors for microcephaly and evaluate historical trends of microcephaly and arboviruses to recognize patterns and anomalies that indicate the beginning of the microcephaly epidemic associated with Zika infection. Methods: The head circumferences of 62,298 newborns was analyzed to identify cases of microcephaly between 2014 and 2017. We compared the groups of newborns…

Dos cartas publicadas en The Lancet y The Lancet Public Health en los últimos meses defienden la necesidad de evaluar de forma independiente la respuesta española ante la covid-19. Estamos de acuerdo, pero nos gustaría complementarlas con tres puntos que nos acercan a la ciencia abierta. Nos referimos a la confusión terminológica, la calidad de…

To better understand the role of individual and lifestyle factors in human disease, an exposome‐wide association study was performed to investigate within a single study anthropometry measures and lifestyle factors previously associated with B‐cell lymphoma (BCL). Within the European Prospective Investigation into Cancer and nutrition study, 2,402 incident BCL cases were diagnosed from 475,426 participants…

Introducción La emergencia sanitaria global causada por la actual pandemia de COVID-19 está suponiendo un enorme desafío a todos los niveles. El uso de la mascarilla puede reducir la propagación de la infección al minimizar la excreción de las gotitas de Flügge. Así, el objetivo de este trabajo es realizar una recopilación de la evidencia…

Aims: The influence of the COVID-19 pandemic on attendance to out-of-hospital cardiac arrest (OHCA) has only been described in city or regional settings. The impact of COVID-19 across an entire country with a high infection rate is yet to be explored. Methods: The study uses data from 8629 cases recorded in two time-series (2017/2018 and…

Background New approaches on paediatric cancer treatment aim to maintain long-term health. As a result of radiotherapy, chemotherapy or surgery, paediatric cancer survivors tend to suffer from any chronic health condition. Endocrine dysfunction represents one of the most common issues and affects bone health. Exercise is key for bone mass accrual during growth, specifically plyometric…

Obesity is a risk factor for several major cancers. Associations of weight change in middle adulthood with cancer risk, however, are less clear. We examined the association of change in weight and body mass index (BMI) category during middle adulthood with 42 cancers, using multivariable Cox proportional hazards models in the European Prospective Investigation into…

Background Polyphenols are natural compounds with anticarcinogenic properties in cellular and animal models, but epidemiological evidence determining the associations of these compounds with thyroid cancer (TC) is lacking. Objectives The aim of this study was to evaluate the relations between blood concentrations of 36 polyphenols and TC risk in EPIC (the European Prospective Investigation into…

Background Adiposity increases endometrial cancer (EC) risk, possibly through inflammation, hyperinsulinemia, and increasing estrogens. We aimed to quantify the mediating effects of adiponectin (anti-inflammatory adipocytokine); interleukin-6, interleukin-1-receptor antagonist, TNF-receptor-1 and -2, and C-reactive protein (inflammatory status biomarkers); C-peptide (hyperinsulinemia biomarker); free estradiol and estrone (estrogen biomarkers) in the adiposity-EC link in postmenopausal women. Methods We…

Background Evidence from the scientific literature shows a significant variation in greenhouse gas (GHG) emissions from the diet, according to the type of food consumed. We aim to analyze the relationship between the daily dietary GHG emissions according to red meat, fruit and vegetables consumption and their relationship with risk of total mortality, and incident…

Families of children with autism spectrum disorder (ASD) often experience much more negative perceptions of their family quality of life (FQoL). To investigate key factors that may shape these experiences, we conducted a case–control study of sixty-one Spanish families (29 with a child with ASD) using a broad psychosocial assessment (e.g., ASD severity, social support,…

Introducción: En España el 16% de la población consume psicofármacos, ansiolíticos, hipnóti-cos y antidepresivos son los más frecuentes. La prevalencia de consumo es el doble en mujeres que en hombres para todos los rangos de edad. Diversos autores y autoras indican que esta diferencia puede deberse a roles y estereotipos de género.Objetivo: Determinar la prevalencia…

Colorectal cancer (CRC) is the third most common cancer worldwide. Population-based, high-resolution studies are essential for the continuous evaluation and updating of diagnosis and treatment standards. This study aimed to assess adherence to clinical practice guidelines and investigate its relationship with survival. We conducted a retrospective high-resolution population-based study of 1050 incident CRC cases from…

COVID-19 constitutes the largest pandemic in the last 100 years. In view of the rapid spread of the virus, it is necessary to study the sociodemographic characteristics, hygiene habits, activity and mobility, and comorbidities of SARS-CoV-2 infection to be able to implement prevention strategies. For this purpose, a survey including the variables of interest was…

Although we received widespread support from more than 50 scientific societies and associations representing public health, medical, and nursing professional communities; there is now a need to define such an evaluation in terms of its timing, scope, and leadership. Here, we suggest three major requisites and four guiding principles, adapted from McKee and colleagues, which…

In acute coronary syndromes (ACSs), longer decision delay – the time patients wait before seeking medical attention after symptoms have started – increases the risk of complications and death. However, many patients wait much longer than recommended and research is needed investigating how patient decision delay can be reduced. In a cross-sectional study of 120…

Sr. Director: A raíz del debate generado en el grupo de trabajo de bibliotecarios/as de ciencias de la salud #Ayudabiblioteca (https://view.genial.ly/5e92f5a5fba9d40d9e580bcb), creado para hacer frente a las demandas de información por la pandemia de COVID-19, queremos exponer la posición de nuestro colectivo respecto a la coautoría en artículos científicos de revisión. Los trabajos de revisión…

Background The nutritional determinants of stroke and, more specifically, the association of frying with the risk of incident stroke have rarely been studied. Objectives Our aim was to evaluate prospectively the association between the consumption of fried food and the risk of incident stroke in the European Prospective Investigation into Cancer and Nutrition study using…

A lo largo de la última década, la perspectiva teórico-activista de despatologización trans ha contribuido a un cambio en la conceptualización de los procesos de tránsito por los géneros. Partiendo de la observación de una interrelación entre psiquiatrización y violencia transfóbica, grupos activistas por la despatologización trans y personas aliadas demandan la retirada de la…

Vivimos tiempos insólitos, cada vez resulta más evidente que el efecto de la actividad de nuestra sociedad dominada por el neoliberalismo tecno-globalizado tiene efectos muy negativos sobre el bienestar social y del planeta, y abundan las iniciativas científicas para intentar caracterizar la situación actual. Desde la geología han propuesto llamar a nuestra era el Antropoceno,…

Abdominal and general adiposity are independently associated with mortality, but there is no consensus on how best to assess abdominal adiposity. We compared the ability of alternative waist indices to complement body mass index (BMI) when assessing all-cause mortality. We used data from 352,985 participants in the European Prospective Investigation into Cancer and Nutrition (EPIC)…

Background Bilirubin, a byproduct of hemoglobin breakdown and purported anti-oxidant, is thought to be cancer preventive. We conducted complementary serological and Mendelian randomization (MR) analyses to investigate whether alterations in circulating levels of bilirubin are associated with risk of colorectal cancer (CRC). We decided a priori to perform analyses separately in men and women based…

To analyze the association between prostate cancer (PCa) risk and night shift work, chronotype, and sleep duration in the context of a population-based case-control study of incident prostate cancer in Spain, a total of 465 PCa cases and 410 controls were analyzed. Selection criteria were: (i) age 40–80 years, and (ii) residence in the coverage…

Objective: To evaluate the relationship between the ownership structure of hospitals and the possibility of their being positioned on the frontier of technical efficiency in the economic crisis period 2010–2012, adjusting for hospital variables and regional characteristics in the areas where the Spanish National Health System (SNHS) hospitals are located. Methods: 230 National Health System hospitals were…

Addressing the characterization of social and economic determinants of health (SDH) properly is a key aspect in conducting a Health Impact Assessment (HIA). This article explores the level of knowledge on HIA environmental and public health professionals have as well as their perception regarding key concepts such as the definition of ‘health’ and the relevance…

Objective Socioeconomic inequalities in colorectal cancer (CRC) survival are a major concern of the Spanish public health system. If these inequalities were mainly due to differences in stage at diagnosis, population-based screening programs might reduce them substantially. We aimed to determine to what extent adverse stage distribution contributed to survival inequalities in a Spanish region…

Sustained B-cell activation is an important mechanism contributing to B-cell lymphoma (BCL). We aimed to validate four previously reported B-cell activation markers predictive of BCL risk (sCD23, sCD27, sCD30, and CXCL13) and to examine their possible mediating effects on the association between anthropometric and lifestyle factors and major BCL subtypes. Pre-diagnostic serum levels were measured…

Hepatocellular carcinoma (HCC) development entails changes in liver metabolism. Current knowledge on metabolic perturbations in HCC is derived mostly from case‐control designs, with sparse information from prospective cohorts. Our objective was to apply comprehensive metabolite profiling to detect metabolites whose serum concentrations are associated with HCC development, using biological samples from within the prospective European…

Background Cardiovascular disease, particularly ischemic heart disease (IHD), is the leading cause of mortality worldwide. Bisphenol A (BPA) is considered an endocrine disruptor and obesogen, present in numerous products of daily use. The aim of this study was to assess the potential association of serum BPA concentrations and the risk of incident IHD in a…

Citrus intake has been suggested to increase the risk of skin cancer. Although this relation is highly plausible biologically, epidemiologic evidence is lacking. We aimed to examine the potential association between citrus intake and skin cancer risk. EPIC is an ongoing multi-center prospective cohort initiated in 1992 and involving ~ 520,000 participants who have been followed-up…

Objetivo Comparar la composición y la funcionalidad de apoyo social de redes personales de personas cuidadoras de Granada y Gipuzkoa en función del sexo y la provincia. Método Estudio transversal con metodología de análisis de redes personales. Se seleccionó una muestra de 66 personas cuidadoras segmentada por sexo en cada provincia. Se recogieron variables de…

Background: Colorectal cancer (CRC) is the most frequently diagnosed cancer in Spain. Socioeconomic inequalities in cancer survival are not documented in Spain. We aim to study the association of socioeconomic inequalities with overall mortality and survival among CRC patients in southern Spain. Methods: We conducted a multilevel population-based cohort study, including CRC cases for the period 2011–…

Introducción El objetivo del estudio es analizar la desigualdad de género en la producción científica de las revistas médicas españolas. Material y método Estudio transversal de las principales revistas médicas españolas clasificadas por SCImago Journal & Country Ranking (n = 24) y sus publicaciones (n = 3.375) durante el año 2017. Se calculó la ratio mujer/hombre de autoría según revista y…

Background: This study aimed at examining the impact of providing healthcare during health emergencies caused by viral epidemic outbreaks on healthcare workers'(HCWs) mental health; to identify factors associated with worse impact, and; to assess the available evidence base regarding interventions to reduce such impact. Method: Rapid systematic review. We searched MEDLINE, Embase, and PsycINFO (inception…

The coronavirus disease 2019 (COVID-19) pandemic has caused an unprecedented global health crisis, with several countries imposing lockdowns to control the coronavirus spread. Important research efforts are focused on evaluating the association of environmental factors with the survival and spread of the virus and different works have been published, with contradictory results in some cases.…

La bioética pública no debería limitarse a ofrecer un conjunto de reglas y modelos de tomas decisiones en «casos difíciles»1, debe ir más allá. Ofrecer razones públicas que contribuyan al diálogo social y a la toma de decisiones institucionales y normativas2. Desde este paradigma, la bioética no debería constreñirse a consejos morales para la toma…

Spain has been hit hard by COVID-19, with more than 300 000 cases, 28 498 confirmed deaths,1 and around 44 000 excess deaths, as of Aug 4, 2020.2 More than 50 000 health workers have been infected, and nearly 20 000 deaths were in nursing homes.3 With a population of 47 million, these data place Spain among the worst affected…

El confinamiento de la población, incluidas las personas investigadoras, pone de manifiesto la necesidad de adaptar la metodología cualitativa, sus técnicas y herramientas, al contexto actual generado por la COVID-19. Internet y los medios o redes sociales posibilitan la recogida de datos textuales, secuencias, imágenes o narrativas sobre una realidad limitada para el acceso a…

4.1 Introduction Mechanical restraint (MR) is used in many countries, including Spain, where non‐harmonized policies between autonomous communities exist. There is a lack of research about interventions at regional levels to reduce their use. 4.2 Aim To analyse data on key outcomes during the implementation of a multicomponent intervention in Andalusia (Spain) to reduce the…

La incidencia y la mortalidad brindan información sobre la carga de la morbilidad del cáncer y los años potenciales de vida perdidos debido al cáncer. Se ha desarrollado el Índice de Privación (IP) como una medida estandarizada para medir la privación socioeconómica en España a nivel de sección censal. Además, se puede combinar la información…

Environmental risks are responsible for one in five of all deaths worldwide. Persistent, bioaccumulative, and toxic substances are chemicals that can subsist for decades in human tissues and the environment. They include heavy metals, organochlorines, polychlorinated biphenyls, organobromines, organofluorines, and polycyclic aromatic hydrocarbons among others. Although humans are often exposed to multiple pollutants simultaneously, their…

Background: Fatty acids impact obesity, estrogens and inflammation, risk factors for ovarian cancer. Few epidemiological studies have investigated the association of fatty acids with ovarian cancer. Methods: Within the European Prospective Investigation into Cancer and nutrition, 1,486 incident ovarian cancer cases were identified. Cox Proportional Hazard models with adjustment for ovarian cancer risk factors were…

Background High carbohydrate intake raises blood triglycerides, glucose, and insulin; reduces HDLs; and may increase risk of coronary heart disease (CHD). Epidemiological studies indicate that high dietary glycemic index (GI) and glycemic load (GL) are associated with increased CHD risk. Objectives The aim of this study was to determine whether dietary GI, GL, and available…

La infancia y la adolescencia marcan, en gran medida, nuestra vida adulta. Las personas más jóvenes están implicadas en una comunidad a su modo y viven también los efectos de la pandemia de la COVID-19. Reflexionar sobre cómo debemos ejercer nuestro papel las personas que nos dedicamos a la atención sanitaria y a la promoción…

Puntos clave La COVID-19 es una infección transmitida por el virus SARS-CoV-2 que, en mayo de 2020, había infectado a más de 5 millones de personas en el mundo y causado probablemente la muerte a más de 325.000 personas. A 18 de mayo, España presentaba la mayor tasa de casos por millón de habitantes y…

The current treatment approach for patients in palliative care (PC) requires a health model based on shared and individualised care, according to the degree of complexity encountered. The aims of this study were to describe the levels of complexity that may be present, to determine their most prevalent elements and to identify factors that may…

The proliferation of arboviruses and their vectors is influenced by a complex interplay between vector, environment and human behaviors. The aim of this work is to analyze the influence of socio-environmental determinants on knowledge and practices regarding arboviruses transmission, among the residents of three communities on the southern border of Mexico. Between June 2017 and…

A recent systematic search of orthopedic surgery literature suggests that scientific risk reporting often deviates from best practices in specific ways (Petrova, Joeris, Sanchez, Salamanca-Fernandez, & Garcia-Retamero, 2018). These deviations could cause dangerous biases in health professionals’ risk interpretations and risk communication practices. To investigate potential vulnerabilities, we conducted the first comparative study estimating the…

Objetivo Analizar la evolución de la epidemia de COVID-19 después del estado de alarma e identificar factores asociados a las diferencias entre las comunidades autónomas. Método Estudio ecológico que utilizó variables epidemiológicas, demográficas, ambientales y sobre la estructura de los servicios sanitarios como variables explicativas. El periodo de análisis fue desde el 15 de marzo…

Background There is a high prevalence of potentially inappropriate prescriptions in primary care. This is associated with more frequent adverse events, lower quality of life and more frequent visits to hospital accident & emergency departments. The aim of the present study is to summarise available evidence on the effectiveness of deprescription interventions in primary care,…

En la actual situación de pandemia, la literatura urge a tener en cuenta el enfoque de género para no profundizar las desigualdades existentes, como ya ocurrió en anteriores epidemias. Esta nota de campo pretende describir una experiencia de aplicación del análisis de género al impacto de la pandemia sobre la salud de la población, realizado…

Varios artículos recientes sugieren que la obesidad es un factor de riesgo para una enfermedad más grave por coronavirus. En este artículo se resume la evidencia científica disponible sobre el papel de la obesidad en COVID-19, con especial atención en las personas más jóvenes y los mecanismos biológicos propuestos para explicar tanto el mayor riesgo…

Xian Lu se mudó a Wuhan para cocinar 400 comidas diarias para personal médico durante el pico de la crisis por COVID-19 en la ciudad. Él es uno de los jóvenes reconocidos por la Organización de las Naciones Unidas debido a su esfuerzo en la lucha solidaria contra la pandemia1. En Granada, una médica de…

La pandemia por coronavirus está provocando una crisis de salud pública mundial sobre la que aún desconocemos gran parte de sus manifestaciones clínicas, comportamiento epidemiológico y abordaje terapéutico. También sus consecuencias de tipo social y económico son impredecibles a medio y largo plazo. España está siendo uno de los países más afectados, tanto en incidencia…

Durante la crisis de salud internacional provocada por la pandemia de COVID-19, además de conocer los datos sobre contagios, muertes y ocupación de camas hospitalarias también es necesario hacer predicciones que ayuden a la gestión de la crisis por parte de las autoridades sanitarias. El presente trabajo tiene como objetivo describir la metodología utilizada para…

Background: Urothelial carcinoma (UC) is the predominant (95%) bladder cancer subtype in industrialised nations. Animal and epidemiological human studies suggest that hormonal factors may influence UC risk. Methods: We used an analytic cohort of 333 919 women from the European Prospective Investigation into Cancer and Nutrition Cohort (EPIC). Associations between hormonal factors and incident UC…

Background In acute coronary syndrome the time elapsed between the start of symptoms and the moment the patient receives treatment is an important determinant of survival and subsequent recovery. However, many patients do not receive treatment as quickly as recommended, mostly due to substantial prehospital delays such as waiting to seek medical attention after symptoms…

Objective Limited information is available on the incidence of rare thyroid cancer (TC) subtypes: anaplastic (ATC) and medullary (MTC). The aim of this study was to describe incidence variations and trends across European countries of all TC subtypes. Materials and methods We used the RARECAREnet database including 80721 TC incident cases in the period 2000–2007…

Objective To explore the views of the Internet in childhood, identifying both health assets and risks. Method A qualitative study was performed using 14 focus groups, eight of which comprised boys and girls, four of which comprised parents and two of which were mixed (children and parents) in primary schools in urban and rural settings…

The treatment of patients with bifascicular block (BFB) and syncope in the absence of structural heart disease (SHD) is not well defined. The objective of our study is to compare pacemaker empirical implantation with the use of electrophysiological studies (EPS). This is a prospective cohort study that included 77 patients with unexplained cardiogenic syncope and BFB without structural…

Los pacientes con cáncer: un grupo de riesgo en la pandemia por COVID-19 La mayoría de las personas diagnosticadas de cáncer son personas de edad avanzada (65 o más años) y con una o varias comorbilidades, lo que aumenta el riesgo de sufrir complicaciones debido a la COVID-193. Además, el cáncer y los tratamientos relacionados…

Las crisis, las emergencias y las épocas de disturbios se han relacionado con un aumento de la violencia interpersonal, incluida la violencia hacia las mujeres. A raíz de la declaración de estado de alarma y confinamiento se han puesto en marcha nuevas medidas encaminadas a paliar el posible impacto de la violencia de género (Plan…

Background. Despite the widespread use of organophosphate (OP) pesticides, information on predictors of children’s exposure to such pesticides is scarce. Objective. To assess exposure to OP pesticides in children 3-11 year-old living in agricultural communities and urban areas from Andalusia (Southern Spain), and to identify the main determinants of exposure. Methods. A longitudinal study was…

Background: While Helicobacter pylori (H. pylori) is the major cause of gastric cancer, it has also been suggested to be involved in colorectal cancer (CRC) development. However, prospective studies addressing H. pylori and CRC are sparse and inconclusive. We assessed the association of antibody responses to H. pylori proteins with CRC in the European Prospective…

Objective: to evaluate the effectiveness of strict social distancing measures applied in China in reducing the incidence and mortality from COVID-19 in two Chinese provinces. Methods: We assessed incidence and mortality rates in Hubei and Guangdong before and after the lockdown period in cities in Hubei. An interrupted time series study was conducted to evaluate the effectiveness of…

La historia de la salud pública en España ha sido escrita principalmente en dos revistas que actualmente siguen siendo un referente en su desarrollo académico y profesional. Con trayectorias dispares, la Revista Española de Salud Pública (1926) y Gaceta Sanitaria (1888) comienzan ahora una política de cooperación que pretende situar a la salud pública en la agenda…

Las políticas de envejecimiento activo presentan el concepto de «ciudadanía activa» como un desafío clave en el ámbito del envejecimiento para los próximos años. La ciudadanía activa ha sido definida de diferentes maneras, en la mayoría de los casos de forma complementaria, describiendo un eclecticismo de actividades participativas que incluye la política, el mercado y…

Background: Little is known about the interlinkages between dietary and plasma non-enzymatic antioxidant capacity (D-NEAC and P-NEAC, respectively) and the body’s antioxidant and inflammation response. Our aim was to explore these associations in 210 participants from two Spanish European Prospective Investigation into Cancer and Nutrition (EPIC) centers. (2) Methods: D-NEAC was estimated using published NEAC…

Objetivo: Analizar un conjunto de indicadores para comprender la variabilidad de la evolución y el impacto de la epidemia de COVID-19. Método: Estudio ecológico de países con más de 200 casos notificados. Se han analizado variables demográficas, de gasto sanitario y de características de los servicios sanitarios como variables explicativas, y las tasas de incidencia,…

A substantial proportion of epithelial ovarian cancer (EOC) arises in the fallopian tube and other epithelia of the upper genital tract; these epithelia may incur damage and neoplastic transformation following sexually transmitted infections (STI) and pelvic inflammatory disease. We investigated the hypothesis that past STI infection, particularly Chlamydia trachomatis, is associated with higher EOC risk in…

Background Environmental factors are believed to account for a substantial burden of type 2 diabetes mellitus (T2DM). Non-persistent environmental pollutants (npEPs) are a group of widely-used chemicals identified as endocrine/metabolic disrupting chemicals and obesogens. The aim of this study was to analyse the potential associations of serum levels of three groups of npEPs with the…

Prisons are epicentres for infectious diseases because of the higher background prevalence of infection, the higher levels of risk factors for infection, the unavoidable close contact in often overcrowded, poorly ventilated, and unsanitary facilities, and the poor access to health-care services relative to that in community settings. 1 Infections can be transmitted between prisoners, staff…

Limited evidence exists on the role of modifiable lifestyle factors on the risk of lymphoma. In this work, the associations between adherence to healthy lifestyles and risks of Hodgkin lymphoma (HL) and non‐Hodgkin lymphoma (NHL) were evaluated in a large‐scale European prospective cohort. Within the European Prospective Investigation into Cancer and Nutrition (EPIC), 2,999 incident…

Introduction For stage III colon cancer (CC), surgery followed by chemotherapy is the main curative approach, although optimum times between diagnosis and surgery, and surgery and chemotherapy, have not been established. Materials and methods We analysed a population-based sample of 1912 stage III CC cases diagnosed in eight European countries in 2009–2013 aiming to estimate:…

Background Numerous studies have analysed the effect of comorbidity on cancer outcomes, but evidence on the association between multimorbidity and short-term mortality among colorectal cancer patients is limited. We aimed to assess this association and the most frequent patterns of multimorbidity associated with a higher short-term mortality risk among colorectal cancer patients in Spain. Methods…

Background Adipose tissue has been acknowledged as a potential target for obesogenic pollutants, including toxic metal(loid)s. However, the presence of these chemicals in the adipose tissue has been poorly characterized. Objective To examine the distributions of adipose tissue concentrations of five toxic metal(loid)s (i.e., arsenic [As], nickel [Ni], lead [Pb], tin [Sn], and titanium [Ti])…

Leukocyte telomere length (LTL) is a heritable biomarker of genomic aging. In this study, we perform a genome-wide meta-analysis of LTL by pooling densely genotyped and imputed association results across large-scale European-descent studies including up to 78,592 individuals. We identify 49 genomic regions at a false dicovery rate (FDR) < 0.05 threshold and prioritize genes…

Introducción El objetivo del estudio es analizar la desigualdad de género en la producción científica de las revistas médicas españolas. Material y método Estudio transversal de las principales revistas médicas españolas clasificadas por SCImago Journal & Country Ranking (n=24) y sus publicaciones (n=3.375) durante el año 2017. Se calculó la ratio mujer/hombre de autoría según…

Aim To investigate the associations between major foods and dietary fibre with subtypes of stroke in a large prospective cohort. Methods and results We analysed data on 418 329 men and women from nine European countries, with an average of 12.7 years of follow-up. Diet was assessed using validated country-specific questionnaires which asked about habitual intake over…

Objectives Both pre‐hospital decision delay – the time patients wait before seeking medical attention after symptoms have started – and high psychological distress after the cardiac episode predict poor prognosis of patients with acute coronary syndromes (ACS). We aimed to identify psychosocial markers of these prognostic factors. Design A cross‐sectional study of 102 consecutive, clinically…

Background: The aim of this study was to analyze the trend in socioeconomic inequalities in mortality in small areas due to several specific causes before (2001–2004, 2005–2008) and during (2009–2012) the economic crisis in seven Spanish cities. Methods: This ecological study of trends, with census tracts as the areas of analysis, was based on three…

Background and Objective Acute bacterial skin and skin structure infections (ABSSSIs) have been defined by the US Food and Drug Administration (FDA) in 2013 to include a subset of complicated skin and skin structure infections commonly treated with parenteral antibiotic therapy. Inpatient treatment of ABSSSIs involves a significant economic burden on the healthcare system. This…

Objectives A centralised approach to health technology assessment (HTA) may facilitate optimal use of HTA resources. A regional approach may increase the chances of local implementation of recommendations. This study aimed to compare assessment procedures in England (centralised HTA approach) with Spain (regional HTA approach) discussing key challenges and opportunities from both approaches. Methods We…

Chronic lymphocytic leukemia (CLL) is an incurable disease accounting for almost one‐third of leukemias in the Western world. Aberrant expression of microRNAs (miRNAs) is a well‐established characteristic of CLL, and the robust nature of miRNAs makes them eminently suitable liquid biopsy biomarkers. Using a nested case‐control study within the European Prospective Investigation into Cancer and…

Endometrial cancer (EC) incidence rates vary ~10‐fold worldwide, in part due to variation in EC risk factor profiles. Using an EC risk model previously developed in the European EPIC cohort, we evaluated the prevention potential of modified EC risk factor patterns and whether differences in EC incidence between a European population and low‐risk countries can…

Physical activity has been associated with lower risks of breast and colorectal cancer in epidemiological studies; however, it is unknown if these associations are causal or confounded. In two-sample Mendelian randomisation analyses, using summary genetic data from the UK Biobank and GWA consortia, we found that a one standard deviation increment in average acceleration was…

Patients diagnosed with coronary heart disease should follow lifestyle recommendations that can reduce their cardiovascular risk (e.g., avoid smoking). However, some patients fail to follow these recommendations and engage in unhealthy behavior. With the aim to identify psychosocial factors that characterize patients at high risk of repeated cardiovascular events, we investigated the relationship between social…

Pro‐inflammatory diets are associated with risk of developing colorectal cancer (CRC), however inconsistencies exist in subsite‐ and sex‐specific associations. The relationship between CRC and combined lifestyle‐related factors that contribute towards a low‐grade inflammatory profile has not yet been explored. We examined the association between the dietary inflammatory potential and an inflammatory profile and CRC risk…

BACKGROUND: Mitochondrial DNA (mtDNA) copy number in peripheral blood has been found to be associated with risk of developing several cancers. However, data on pancreatic ductal adenocarcinoma (PDAC) are very limited. METHODS: To further our knowledge on this topic we measured relative mtDNA copy number by a quantitative real-time PCR assay in peripheral leukocyte samples…

Background Although lifestyle factors have been studied in relation to individual non-communicable diseases (NCDs), their association with development of a subsequent NCD, defined as multimorbidity, has been scarcely investigated. The aim of this study was to investigate associations between five lifestyle factors and incident multimorbidity of cancer and cardiometabolic diseases. Methods In this prospective cohort…

Background and aim Coping can be defined as the cognitive efforts and behavioral practices that people develop in situations which they consider to be stressful. In people with Chronic Non-Cancer Pain (CNCP), coping is influenced by the biological, psychological, and socio-cultural resources available to them. The aim of this systematic review is to evaluate the…

Background Physical, psychological and sexual Intimate Partner Violence (IPV) have been described in the literature as different types of IPV experienced by women during pregnancy all over the world. Objectives To systematically review and summarize the empirical evidence on the links between IPV during pregnancy and the perinatal health of mothers and fetuses/neonates. Search Strategy…

The aim of this study conducted in Spain was to analyze and compare burden, severe burden, and satisfaction among informal caregivers in relation to health-related quality of life (HRQoL), type and duration of caregiving, perceived social support, and use of social and health care services. We performed multivariate analyses to identify variables associated with caregiver…

Bisphenol A (BPA) is considered an endocrine disruptor and it is present in numerous products of daily use. The aim of this study was to analyze serum BPA concentrations in a subcohort of the Spanish European Prospective Investigation into Cancer and Nutrition (EPIC), as well as to identify potential predictors of the exposure. The population…

Background Even though in situ breast cancer (BCIS) accounts for a large proportion of the breast cancers diagnosed, few studies have investigated potential risk factors for BCIS. Their results suggest that some established risk factors for invasive breast cancer have a similar impact on BCIS risk, but large population-based studies on lifestyle factors and BCIS…

Introducción Bexsero® (4CMenB), vacuna contra el meningococo B, fue autorizada en Europa en 2013. En España, a pesar de que el meningococo B es la principal causa de enfermedad meningocócica invasiva (EMI), Bexsero® está recomendada y financiada para pacientes con alto riesgo de EMI pero no de forma sistemática en el calendario vacunal del SNS.…

Background Scientific literature has provided clear evidence of the profound impact of sexual violence on women’s health, such as somatic disorders and mental adverse outcomes. However, consequences related to obstetric complications are not yet completely clarified. This study aimed to assess the association of lifetime exposure to intimate partner sexual violence with eclampsia.   Methods…

Context. Patients with adrenocortical tumors have been frequently observed to have nonadrenal neoplasia. Objective. To investigate whether patients with benign adrenocortical tumors have a higher likelihood of having nonadrenal neoplasia detected. Design and Participants. Case-control study of patients with benign adrenocortical tumors (cases; n = 400) and normal adrenal glands (controls; n = 400), who underwent repeated abdominal cross-sectional…

Background Cancer Antigen 125 (CA125) is currently the best available ovarian cancer screening biomarker. However, CA125 has been limited by low sensitivity and specificity in part due to normal variation between individuals. Personal characteristics that influence CA125 could be used to improve its performance as screening biomarker. Methods We developed and validated linear and dichotomous…

Aims/hypothesis Type 1 and type 2 diabetes differ with respect to pathophysiological factors such as beta cell function, insulin resistance and phenotypic appearance, but there may be overlap between the two forms of diabetes. However, there are relatively few prospective studies that have characterised the relationship between autoimmunity and incident diabetes. We investigated associations of…

Objetivo: Mepolizumab está indicado como tratamiento adicional del asma eosinofílica refractaria grave. Las diferencias observadas en  subgrupos poblacionales según recuento eosinofílico plasmático,  existencia de pacientes con altos niveles de inmunoglobulina E  candidatos a omalizumab y mepolizumab, e impacto económico de  mepolizumab obligan a realizar estudios económicos para tomar  decisiones clínicas eficientes. El objetivo fue realizar un análisis de  coste/eficacia e impacto…

Purpose The evidence from the literature regarding the association of dietary factors and risk of prostate cancer is inconclusive. Methods A nutrient-wide association study was conducted to systematically and comprehensively evaluate the associations between 92 foods or nutrients and risk of prostate cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC). Cox proportional…

Purpose Advanced glycation end products (AGEs) can be formed in foods by the reaction of reducing sugars with proteins, and have been shown to induce insulin resistance and obesity in experimental studies. We examined the association between dietary AGEs intake and changes in body weight in adults over an average of 5 years of follow-up. Methods…

The main aim of this study was to determine the association of various clinical, functional and pharmacological factors with the physical (PCS) and mental (MCS) summary components of the health-related quality of life (HRQoL) of community-dwelling older adults. Design: Cross-sectional study. Patients and setting: Sample of 573 persons aged over 65 years, recruited at 12…

Introduction Despite the enormous potential for adverse events in primary healthcare (PHC), the knowledge about how to improve patient safety in this context is still sparse. We describe the methods for the development and evaluation of an intervention targeted at PHC professionals to improve patient safety in Spanish PHC centres. Methods and analysis The intervention…

Background & Aims Early-onset colorectal cancer (CRC, in persons younger than 50 years old) is increasing in incidence; yet, in the absence of a family history of CRC, this population lacks harmonized recommendations for prevention. We aimed to determine whether a polygenic risk score (PRS) developed from 95 CRC-associated common genetic risk variants was associated…

Purpose With better access to early diagnosis and appropriate treatment, cervical cancer (CC) burden decreased in several European countries. In Eastern European (EE) countries, which accessed European Union in 2004, CC survival was worse than in the rest of Europe. The present study investigates CC survival differences across five European regions, considering stage at diagnosis…

Heavy metals and other toxic elements are frequently detected in humans. Rare earth elements (REE) have arisen as a novel group of substances considered as emerging pollutants due to its dependence for high tech industry. We designed a study aimed to conduct the biomonitoring a total of 45 inorganic elements in the population of Andalusia…

Background Cancer is a major public health problem worldwide. The GLOBOCAN estimated 18.1 million new cases of cancer and 9.6 million deaths from cancer in 2018. In some of the more frequent cancers, mortality can be significantly reduced through cancer screening programs. Nevertheless, socially disadvantaged groups have difficulties in benefitting from these screening programs, especially…

Multiple Criteria Decision Analysis (MCDA) has emerged as a likely methodology for Health Technology Assessment (HTA). However limited empirical evidence is available on its use by decision-makers and only as part of single-setting exercises, without cross-county studies available. This pilot study applies the Advance Value Framework (AVF), an MCDA methodology for HTA based on multi-attribute…

Background: Except for a documented increase in osteoprotegerin (OPG) concentrations with older age, data on determinants of soluble Receptor Activator of Nuclear Factor κB (sRANKL) and OPG concentrations in women are limited. We evaluated reproductive and lifestyle factors as potential sources of variation in circulating sRANKL and OPG concentrations in pre- and postmenopausal women. Methods:…

Background: The aim of this study was to develop a spending predictor model to evaluate the direct costs associated with the management of ABSSSIs from the National health-care provider’s perspective of Italy, Romania, and Spain. Methodology: A decision-analytic model was developed to evaluate the diagnostic and clinical pathways of hospitalized ABSSSI patients based on scientific…

Experimental studies have reported on the anti-inflammatory properties of polyphenols. However, results from epidemiological investigations have been inconsistent, and especially studies using biomarkers for assessment of polyphenol intake have been scant. We aimed to characterize the association between plasma concentrations of 35 polyphenol compounds and low-grade systemic inflammation state as measured by high-sensitivity C-reactive protein…

Pancreatic cancer (PC) is a highly fatal cancer with currently limited opportunities for early detection and effective treatment. Modifiable factors may offer pathways for primary prevention. In this study, the association between the Healthy Lifestyle Index (HLI) and PC risk was examined. Within the European Prospective Investigation into Cancer and Nutrition cohort, 1113 incident PC…

Aim The present systematic review aimed at assessing the degree of compliance with supportive periodontal/peri‐implant therapy as well as identifying patient‐related factors that could potentially play a role on patient compliance. Methods Electronic and manual literature searches were carried out to assess patient compliance during maintenance. Main outcomes were compliance definition, degree of compliance and…

Background. Organized screening programs often rely on written materials to inform the public. In the United Kingdom, women invited for cervical cancer screening receive a leaflet from the National Health Service (NHS) to support screening decisions. However, information about screening may be too complex for people to understand, potentially hindering informed decision making. Objectives. We…

Background Metabolomics is a promising molecular tool to identify novel etiologic pathways leading to cancer. Using a targeted approach, we prospectively investigated the associations between metabolite concentrations in plasma and breast cancer risk. Methods A nested case-control study was established within the European Prospective Investigation into Cancer cohort, which included 1624 first primary incident invasive…

Receiver operating characteristic (ROC) analysis is used for comparing predictive models in both model selection and model evaluation. ROC analysis is often applied in clinical medicine and social science to assess the tradeoff between model sensitivity and specificity. After fitting a binary logistic or probit regression model with a set of independent variables, the predictive…

Objetivo Describir la asociación entre la caminabilidad del barrio de residencia y la mortalidad. Método Estudio ecológico de áreas pequeñas. Se calcularon las razones de mortalidad estandarizadas (RME) y el Walk Score© en cada sección censal. Los valores se compararon con pruebas paramétricas y no paramétricas. Resultados En los hombres, las RME medias para enfermedades…

Background One of the greatest effects of the financial crisis in Spain has been the enormous increase in the number of evictions. Several studies have shown the association of evictions with different aspects of the physical and mental health. Furthermore, evictions have been associated with an increased risk of suicide. Our objective was to evaluate…

Evidence suggests an influence of sex hormones on cutaneous melanoma risk, but epidemiologic findings are conflicting. We examined the associations between use of oral contraceptives (OCs) and menopausal hormone therapy (MHT) and melanoma risk in women participating in the European Prospective Investigation into Cancer and Nutrition (EPIC). EPIC is a prospective cohort study initiated in…

Importance  Soft drinks are frequently consumed, but whether this consumption is associated with mortality risk is unknown and has been understudied in European populations to date. Objective  To examine the association between total, sugar-sweetened, and artificially sweetened soft drink consumption and subsequent total and cause-specific mortality. Design, Setting, and Participants  This population-based cohort study involved…

Longitudinal targeted maximum likelihood estimation (LTMLE) has very rarely been used to estimate dynamic treatment effects in the context of time‐dependent confounding affected by prior treatment when faced with long follow‐up times, multiple time‐varying confounders, and complex associational relationships simultaneously. Reasons for this include the potential computational burden, technical challenges, restricted modeling options for long…

Higher circulating 25-hydroxyvitamin D levels (25(OH)D) have been found to be associated with lower risk for colorectal cancer (CRC) in prospective studies. Whether this association is modified by genetic variation in genes related to vitamin D metabolism and action has not been well studied in humans. We investigated 1307 functional and tagging single-nucleotide polymorphisms (SNPs;…

Background Bile acids have been proposed to promote colon carcinogenesis. However, there are limited prospective data on circulating bile acid levels and colon cancer risk in humans. Methods Associations between pre-diagnostic plasma levels of 17 primary, secondary and tertiary bile acid metabolites (conjugated and unconjugated) and colon cancer risk were evaluated in a nested case-control…

Introduction Beverage consumption is a modifiable risk factor for type 2 diabetes (T2D), but there is insufficient evidence to inform the suitability of substituting 1 type of beverage for another. Objective The aim of this study was to estimate the risk of T2D when consumption of sugar-sweetened beverages (SSBs) was replaced with consumption of fruit…

Objective To summarize the results from observational studies examining the risk of fetal and neonatal death (perinatal death) as a function of the experience of Intimate Partner Violence (IPV) during pregnancy and examine the influence of socioeconomic context indicators on this association. Data sources Bibliographic searches were conducted in PubMed, EMBASE, CINAHL, and LILACS until…

Objective To compare the survival among patients with chronic kidney disease who had optimal starts of renal replacement therapy, dialysis or hemodialysis, with patients who had suboptimal starts. Methods A retrospective cohort consisting of >18 year-old patients who started renal replacement therapy, using peritoneal dialysis or hemodialysis, in any public hospital or associated center of…

Levels of dialkylphosphate (DAP) metabolites were measured in hair and urine of children that lived close to intensively farmed areas of Almeria (Southeast Spain). The levels were used as proxies for exposure of these children to organophosphate pesticides (OPs). Determinants of exposure to DAPs were also examined. Urine and hair samples were collected from 222…

Polyphenols are bioactive compounds with several anticarcinogenic activities; however, human data regarding associations with thyroid cancer (TC) is still negligible. Our aim was to evaluate the association between intakes of total, classes and subclasses of polyphenols and risk of differentiated TC and its main subtypes, papillary and follicular, in a European population.The European Prospective Investigation…

Purpose To comparatively assess the prevalence rates of potentially inappropriate medications (PIMs) obtained by the former and latest versions of American Geriatrics Society Beers Criteria (AGS BC) and screening tool of older person’s potentially inappropriate prescriptions (STOPP), and analyze the factors of influence on PIM. Methods Cross-sectional study including 582 community-dwelling older adults over the…

Background: Our main objective was to evaluate the fundamental biases detected in studies assessing the effects the Great Recession had on health for the case of Spain. As secondary objectives we presented methods to control these biases and to discuss the results of the studies in question if they had controlled for them. Methods: We…

This study aimed to assess the association between exposure to chromium and neuropsychological development among children. A cross-sectional study was conducted with 393 children aged 6–11 years old randomly selected from State-funded schools in two provinces in Southern Spain (Almeria and Huelva), in 2010 and 2012. Chromium levels in urine and hair samples were analyzed…

Several studies have reported associations of hypertension with cancer, but not all results were conclusive. We examined the association of systolic (SBP) and diastolic (DBP) blood pressure with the development of incident cancer at all anatomical sites in the European Prospective Investigation into Cancer and Nutrition (EPIC). Hazard ratios (HR) (95% confidence intervals) were estimated…

We investigated what factors may foster or hinder physicians’ cancer screening risk literacy–specifically the ability to understand evidence regarding screening effectiveness and make evidence-based recommendations to patients. In an experiment, physicians in training (interns and residents) read statistical information about outcomes from screening for cancer, and had to decide whether to recommend it to a…

Background & Aims There is an unclear association between intake of fish and long-chain n-3 polyunsaturated fatty acids (n-3 LC-PUFAs) and colorectal cancer (CRC). We examined the association between fish consumption, dietary and circulating levels of n-3 LC-PUFAs, and ratio of n-6:n-3 LC-PUFA with CRC using data from the European Prospective Investigation into Cancer and…

Objetivo Comparar las diferencias en la producción científica mundial sobre paternidad y maternidad (cantidad, momento de inicio y evolución temporal), conocer la distribución geográfica internacional de artículos sobre paternidad, y examinar la relación del índice de desarrollo humano (IDH) y del índice global de brecha de género (IGBG) con el número de artículos sobre paternidad.…

Background: Energy balance is defined as the difference between energy expenditure and energy intake. The current state of knowledge supports the need to better integrate mechanistic approaches through effective studies of energy balance in the cancer population because of an observed significant lack of adherence to healthy lifestyle recommendations. To stimulate changes in breast cancer…

The objective of this article is to analyze the ratio of cost-effectiveness and budgetary impact of lenalidomide treatment in patients with multiple myeloma who have undergone autologous transplant in Spain. The analyses were based on clinical trials CALGB 100104 and IFM 2005-02, from the perspective of the National Health System. The alternatives compared were the…

Background: To analyze the potential effect of social inequality on pancreatic cancer risk in Western Europe, by reassessing the association within the European Prospective Investigation into Cancer and Nutrition (EPIC) Study, including a larger number of cases and an extended follow-up. Methods: Data on highest education attained were gathered for 459,170 participants (70% women) from…

Introduction Stillbirth, one of the urgent concerns of preventable perinatal deaths, has wide-reaching consequences for society. We studied secular stillbirth trends by maternal socioeconomic status (SES) in Spain. Methods We developed a population-based observational study, including 4 083 919 births during 2007–15. We estimate stillbirth rates and secular trends by maternal SES. We also evaluated…

Objective The main aims of this paper are to analyse the monetary value of informal care time using different techniques and to identify significant variables associated with the number of caregiving hours. Data and methods A multicentre study in two Spanish regions in adult caregivers was conducted. A total sample of 604 people was available.…

Four epidemiologic studies have assessed the association between nut intake and pancreatic cancer risk with contradictory results. The present study aims to investigate the relation between nut intake (including seeds) and pancreatic ductal adenocarcinoma (PDAC) risk in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Cox proportional hazards models were used to estimate…

In Spain, the average waiting time for a specialist consultation is 58 days. A determinant factor that contributes to this situation is the poor communication between primary care and specialised care, which is mainly due to the waiting days for a consultation, number of avoided/avoidable face-to-face referrals, and waiting days for the resolution of the…

Objetivo Describir la evolución de la morbilidad psíquica en la población adulta española en 2006, 2011 y 2017. Estudiar la salud mental en 2017, determinando la prevalencia de morbilidad psíquica, consumo de psicofármacos, diagnóstico y salud autopercibida. Todo ello tanto en el ámbito nacional como por comunidades autónomas, y diferenciando entre hombres y mujeres. Método…

Selenoprotein genetic variations and suboptimal selenium (Se) levels may contribute to the risk of colorectal cancer (CRC) development. We examined the association between CRC risk and genotype for single nucleotide polymorphisms (SNPs) in selenoprotein and Se metabolic pathway genes. Illumina Goldengate assays were designed and resulted in the genotyping of 1040 variants in 154 genes…

Objective To compare the use of health technology assessment (HTA) as a tool to support pricing and reimbursement (P&R) of new medicines in Spain with England, Sweden, France and Germany. Method For each country, the literature is used to identify the purpose and timing of the P&R decision, the HTA and decision-making procedures used to…

Objetivo Evaluar el acceso al mercado de los medicamentos huérfanos en España que a fecha de 31 de diciembre de 2017 tuvieran vigente su designación, y para aquellos comercializados en España estimar los tiempos entre la asignación de código nacional (CN) por parte de la Agencia Española de Medicamentos y Productos Sanitarios (AEMPS) y la…

Background: There is uncertainty about the relevance of animal foods to the etiology of ischemic heart disease (IHD). We examined meat, fish, dairy products and eggs and risk for IHD in the pan-European EPIC cohort. Methods: A prospective study of 409,885 men and women in nine European countries. Diet was assessed using validated questionnaires, calibrated…

Population‐based cancer registry data from three Spanish areas were used to assess the patterns of care and adherence to guidelines for cutaneous malignant melanoma. We included 934 cases diagnosed in 2009–2013. Completeness of the pathology reports, imaging for detecting distant metastasis and the use of sentinel lymph node biopsy (SLNB) were analysed. The proportion of…

Evaluar el impacto de la formación entre iguales de la Escuela de Pacientes sobre la salud autopercibida y los hábitos de vida de las personas con enfermedades crónicas. Diseño Descriptivo, transversal de evaluación cuantitativa pretest/postest. Emplazamiento Andalucía. Participantes Novecientos sesenta y cuatro pacientes con diabetes, fibromialgia e insuficiencia cardíaca participantes en la Escuela de Pacientes…

Alcohol consumption is associated with higher risk of breast cancer (BC); however, the biological mechanisms underlying this association are not fully elucidated, particularly the extent to which this relationship is mediated by sex hormone levels. Circulating concentrations of estradiol, testosterone, their free fractions and sex‐hormone binding globulin (SHBG), were examined in 430 incident BC cases…

En 2009, Grant y Booth identificaron hasta 14 tipos diferentes de revisiones de la literatura, desde la revisión narrativa hasta la más actual umbrella review , y afirmaban que muchos de estos tipos de revisiones no tienen una metodología precisa ni son mutuamente excluyentes. Una de las formas de síntesis de la literatura más actuales…

Background Colorectal cancer (CRC) is the second cause of tumour mortality in Spain and Europe. To date, no studies have been conducted in Spain to evaluate the spatial and temporal distribution of the excess risk of death during hospitalisation for CRC. Methods A cohort was constructed of all episodes of hospitalisation in Spain due to…

Introducción El objetivo de este artículo fue explorar, analizar y sintetizar las experiencias emocionales de profesionales sanitarios de donación y trasplantes. Método Se realizó una revisión sistemática cualitativa en Medline, Science Direct y la Biblioteca Virtual del Sistema Sanitario Público de Andalucía. Se seleccionaron 16 artículos originales, realizando una evaluación cualitativa y síntesis narrativa. Resultados…

Metabolomics may reveal novel insights into the aetiology of prostate cancer, for which few risk factors are established. We investigated the association between patterns in baseline plasma metabolite profile and subsequent prostate cancer risk, using data from 3057 matched case‐control sets from the European Prospective Investigation into Cancer and Nutrition (EPIC). We measured 119 metabolite…

Background: CA125 is the most promising ovarian cancer screening biomarker to date. Multiple studies reported CA125 levels vary by personal characteristics, which could inform personalized CA125 thresholds. However, this has not been well described in premenopausal women. Methods: We evaluated predictors of CA125 levels among 815 premenopausal women from the New England Case Control Study…

The financial crisis has caused an exponential increase of home foreclosures in Spain. Recent studies have shown the effects that foreclosures have on mental and physical health. This study explores these effects on a sample of adults in the city of Granada (Spain), in terms of socio-demographic, socio-economic and process characteristics. A cross-sectional survey was…

Background Mortality from malignant cutaneous melanoma increased alarmingly during the second half of the 20th century in Spain and other European countries. Objective The aim was to analyze sex and age‐specific trends in melanoma mortality in Spain in the period 1982‐2016. Methods European age‐standardized melanoma mortality rates during the period 1982‐2016 were calculated from mortality…

Background The objective of this review was to investigate trends in clinical trial design, specifically, the primary outcomes used, interpretation of results, and the magnitude of the benefits described in phase III controlled clinical trials in the first‐line treatment of patients with advanced non‐small cell lung cancer (NSCLC). Methods Seventy‐six trials published between 2000 and…

Andalusia is a region in the south of Spain with 8,4 million inhabitants of which 1,3 million are over 65 years old. Andalusia has been recognized as Reference Site by the European Commission within the European Innovation Partnership on Active and Healthy Aging. The Regional Ministry of Health of Andalusia has put in place strategies…

Objetivo Evaluar el impacto del Plan de Promoción de la Autonomía Personal y Prevención de la Dependencia de Andalucía (2016-2020) en 13 organismos públicos participantes tras su primer año, y analizar la usabilidad y la fiabilidad de la escala de evaluación del impacto que se ha empleado. Método El Plan aborda la promoción de la…

Una vez más, presentamos el informe de la actividad realizada por el equipo editorial a lo largo del año anterior y los datos de desempeño de la revista, con el fin de rendir cuentas a nuestros/as lectores/as, a las personas socias de SESPAS y a la sociedad. El documento permite analizar los avances y las…

The associations of individual dietary fatty acids with prostate cancer risk have not been examined comprehensively. We examined the prospective association of individual dietary fatty acids with prostate cancer risk overall, by tumor subtypes, and prostate cancer death. 142,239 men from the European Prospective Investigation into Cancer and Nutrition who were free from cancer at…

Background Earlier age at menopause has been associated with increased risk of coronary heart disease (CHD), but the shape of association and role of established cardiovascular risk factors remain unclear. Therefore, we examined the associations between menopausal characteristics and CHD risk; the shape of the association between age at menopause and CHD risk; and the…

OBJECTIVE To estimate the causal association between intake of dairy products and incident type 2 diabetes. RESEARCH DESIGN AND METHODS The analysis included 21,820 European individuals (9,686 diabetes cases) of the EPIC-InterAct case-cohort study. Participants were genotyped, and rs4988235 (LCT-12910C>T), a SNP for lactase persistence (LP) which enables digestion of dairy sugar, i.e., lactose, was…

Objetivo Evaluar la evidencia sobre el uso de heurísticos de representatividad, disponibilidad, anclaje y ajuste y exceso de confianza en la práctica clínica real, específicamente en el ámbito de la Atención Primaria. Diseño Revisión panorámica (scoping review). Fuentes de datos Bases de datos de OvidMedline, Scopus, PsycoINFO, Cochrane Library y PubMed. Con el fin de…

People with low statistical numeracy have difficulties understanding numerical information. For instance, they often misunderstand the probability of experiencing side effects, which could reduce adherence to medical treatments. We investigated whether presenting information about probability using a method based on the direct experience of events influences the accuracy of probability estimates compared to viewing a…

Published associations between dietary folate and bladder cancer risk are inconsistent. Biomarkers may provide more accurate measures of nutrient status. This nested case‐control analysis within the European Prospective Investigation into Cancer and Nutrition (EPIC) investigated associations between pre‐diagnostic serum folate, homocysteine, vitamins B6 and B12 and the risk of urothelial cell carcinomas of the bladder…

Objective To identify and characterize the interventions that aimed to improve cancer treatment and follow‐up care in socially disadvantaged groups. To summarize the state‐of‐the‐art for clinicians and researchers. Methods We conducted a systematic review following PRISMA guidelines. Eligible studies were randomized controlled trials and quasi‐experimental studies with a control group (usual care or enhanced usual…

Objectives and setting Although psychotropic drugs are used to treat mental health disorders, little evidence analyses the effects the 2008 economic downturn had on psychotropic drug consumption in the case of Spain. We analyse these effects, considering both gender and employment situation. Participants We used the microdata from the face-to-face cross-sectional population-based Spanish National Health…

Previous prospective studies assessing the relationship between circulating concentrations of vitamin D and prostate cancer risk have shown inconclusive results, particularly for risk of aggressive disease. In this study, we examine the association between prediagnostic concentrations of 25-hydroxyvitamin D [25(OH)D] and 1,25-dihydroxyvitamin D [1,25(OH)2D] and the risk of prostate cancer overall and by tumor characteristics.…

Gaceta Sanitaria viene intensificando el trabajo por la integridad y la eficiencia en la publicación científica desde el año 20171, en cumplimiento con el compromiso adquirido mediante la adhesión a la iniciativa REWARD liderada por The Lancet2,3. Las revistas científicas tenemos una enorme responsabilidad en el proceso de selección, edición y publicación de la ciencia.…

There is growing evidence of the protective role of the Mediterranean diet (MD) on cancer. However, no prospective study has yet investigated its influence on lymphoma. We evaluated the association between adherence to the MD and risk of lymphoma and its subtypes in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. The analysis…

Gallstones, a common gastrointestinal condition, can lead to several digestive complications and can result in inflammation. Risk factors for gallstones include obesity, diabetes, smoking and physical inactivity, all of which are known risk factors for colorectal cancer (CRC), as is inflammation. However, it is unclear whether gallstones are a risk factor for CRC. We examined…

Background & Aims Evidence on the association between physical activity and risk of hepatobiliary cancers is inconclusive. We examined this association in the European Prospective Investigation into Cancer and Nutrition cohort (EPIC). Methods We identified 275 hepatocellular carcinoma (HCC) cases, 93 intrahepatic bile duct cancers (IHBC), and 164 non-gallbladder extrahepatic bile duct cancers (NGBC) among…

Background The use of biomarkers of environmental exposure to explore new risk factors for pancreatic cancer presents clinical, logistic, and methodological challenges that are also relevant in research on other complex diseases. Objectives First, to summarize the main design features of a prospective case-control study –nested within the European Prospective Investigation into Cancer and Nutrition…

Social support is an important predictor of the health of a population. Few studies have analyzed the influence of caregivers’ personal networks from a gender perspective. The aim of this study was to analyze the composition, structure, and function of informal caregiver support networks and to examine gender differences. It also aimed to explore the…

Background The use of biomarkers of environmental exposure to explore new risk factors for pancreatic cancer presents clinical, logistic, and methodological challenges that are also relevant in research on other complex diseases. Objectives First, to summarize the main design features of a prospective case-control study –nested within the European Prospective Investigation into Cancer and Nutrition…

The objective of this systematic literature review is to examine the impact of interventions to improve cardiovascular disease healthcare provided to people living in rural areas. Systematic electronic searches were conducted in Medline, CINAHL, Embase, Scopus, and Web of Knowledge in July 2018. We included clinical trials assessing the effectiveness of interventions to improve cardiovascular…

Ovarian cancer risk factors differ by histotype; however, within subtype there is substantial variability in outcomes. We hypothesized that risk factor profiles may influence tumor aggressiveness, defined by time between diagnosis and death, independent of histology. Among 1.3 million women from 21 prospective cohorts, 4,584 invasive epithelial ovarian cancers were identified and classified as highly…

Objetivo Conocer la valoración de personas migrantes sobre su acceso al sistema sanitario tras la entrada en vigor del Real Decreto-Ley16/2012 y sobre el efecto que han podido producir los recortes económicos en dicho acceso. Método Estudio cualitativo fenomenológico con entrevistas semiestructuradas, realizado en Andalucía, en dos fases (2009-2010 y 2012-2013), con 36 participantes. Se…

Classical epidemiology has focused on the control of confounding, but it is only recently that epidemiologists have started to focus on the bias produced by colliders. A collider for a certain pair of variables (e.g. an outcome Y and an exposure A) is a third variable (C) that is caused by both. In a directed…

Cardiac patients who have social support generally have better prognosis than patients who lack social support. Several theoretical mechanisms have been proposed to explain this protective effect, including the capacity of social support to buffer the negative effects of stress. We tested this buffering effect in a study of patients hospitalized for acute coronary syndrome…

MTHFR is a key enzyme in folate metabolism. Some genetic polymorphisms code for a less efficient enzyme, increasing serum concentrations of homocysteine. This has been associated with inadequate feto-maternal circulation and increased risk of spontaneous abortion. Paroxonase 1 (PON1) is a multifunctional enzyme that can detoxify homocysteine through its homocysteine thiolactonase activity. We evaluate the…

Purpose Coffee and tea constituents have shown several anti-carcinogenic activities in cellular and animal studies, including against thyroid cancer (TC). However, epidemiological evidence is still limited and inconsistent. Therefore, we aimed to investigate this association in a large prospective study. Methods The study was conducted in the EPIC (European Prospective Investigation into Cancer and Nutrition)…

Purpose: Renal cell carcinoma (RCC) has the potential for cure with surgery when diagnosed at an early stage. Kidney injury molecule-1 (KIM-1) has been shown to be elevated in the plasma of RCC patients. We aimed to test whether plasma KIM-1 could represent a means of detecting RCC prior to clinical diagnosis. Experimental Design: KIM-1…